Monday, June 27, 2022

What Antibiotics Treat Sinus Infections In Adults

What Are The Most Common Antibiotics Used For Sinusitis

Discussion with a patient with sinusitis who requests antibiotics

Amoxicillin remains the drug of choice for acute, uncomplicated bacterial sinusitis. Amoxicillin is most effective when given frequently enough to sustain adequate levels in the infected tissue. While often prescribed twice daily, it is even more effective if taken in 3 or 4 divided doses. Amoxicillin is typically prescribed for 7-10 days at a time. While it is critical to finish the entire 10 day course of antibiotics when treating strep throat, there is evidence that shorter courses of treatment may be sufficient for most cases of sinusitis. Amoxicillin is closely related to the parent compound penicillin and should not be prescribed in patients who are penicillin allergic.

Cephalosporins and Augmentin are considered broad-spectrum antibiotics because they have enhanced effectiveness against a wider range of bacteria, including those that are resistant to ordinary penicillin or amoxicillin. If the patient does not improve within the first week on amoxicillin, a change to Augmentin or to a cephalosporin such as Ceftin, Cefzil, Omnicef, or Suprax is reasonable. Although these drugs have a similar mechanism of action to penicillin, they generally can be taken in adequate doses once or twice daily. These medications should be used with extreme caution in patients with a history of penicillin allergy, as cross-reaction may occur.

Additional resources:

Which Types Of Doctors Treat Sinusitis And Sinus Infections

  • Many sinus infections can be treated by your primary care physician or an Internal Medicine doctor.
  • However, it is not unusual to consult an ENT specialist,
  • Infectious disease specialist,
  • Allergist or Immunologist.
  • With some complex sinus infections, a surgeon who specializes in sinus surgery may be necessary to consult.
  • When To Consider Antibiotics For Sinus Infections

    AAAAI advises that antibiotics for sinus infections should be considered only if you develop a fever of 102° F or higher, you have severe face pain and tenderness, your symptoms last longer than a week or so, or your symptoms improve and then worsen again.

    Some patients with acute sinusitis do need antibiotics, and if they continue with a worsening infection without treatment, they can suffer dramatic complications such as loss of vision, meningitis, or brain abscess, Patel says.

    If your doctor says you need an antibiotic, ask for generic amoxicillin/clavulanate, according to guidelines from UpToDate, which provides evidence-based treatment information to healthcare providers. Its usually the best choice and works as well as more expensive brand-name antibiotics.

    Avoid taking fluoroquinolones, a group of antibiotics that includes ciprofloxacin and levofloxacin . Although widely used, the antibiotics are inappropriate for treating sinus infections and they pose serious risks.

    In 2016, after a safety review, the Food and Drug Administration linked fluoroquinolones to disabling and potentially permanent side effects. The agency advised against using the drugs to treat common illnessesbronchitis, sinus infections, and urinary tract infections.

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    Sinus Infection Definition And Facts

    • Sinusitis or sinus infection is inflammation of the air cavities within the passages of the nose.
    • Sinusitis can be caused by infection, allergies, and chemical or particulate irritation of the sinuses.
    • The fastest way to get rid of a sinus infection can include medications, home remedies, alternative therapies, and surgery.
    • Most people do not spread sinus infections to other people.
    • Sinusitis may be classified as acute sinus infection, subacute sinus infection, chronic sinus infection, infected sinusitis, and noninfectious sinusitis.
    • Sinusitis signs and symptoms include

    When Is A Z

    Table 2 from Role of antibiotics in sinusitis.

    Spoiler alert: its not! Because its so easy to use, the Z-Pak used to be a go-to prescription for sinus infections. But it turns out that only a minority of these prescriptions are appropriate because the majority of sinus infections are viral and not bacterial. In fact, studies have found that about a third of antibiotic prescriptions for sinus infections, sore throats, and ear infections arent even necessary. Overprescribing antibiotics increases the chance that bacteria will become resistant to them and disrupt the gut bacterial flora for months. Indeed, azithromycin is no longer recommended for bacterial sinus infections due to the risk of resistance.

    If you have a sinus infection, expect to feel lousy for several days. After all, your body is waging war against an infection. You might experience:

    • A runny nose

    • A sore throat

    • A cough

    Youre also likely to feel more tired and achy and maybe even experience a low-grade fever. Most people improve within a week, but symptoms can last up to 2 weeks. Coughs can linger for a week after that.

    Treating a sinus infection boils down to whether its viral or bacterial. Colds, for example, are viral. And antibiotics like the Z-Pak are not effective against viral infections. In fact, viral sinus infections have no cure. Treatment is aimed at managing symptoms and includes:

    If you still dont feel better, your healthcare provider may suggest nasal or lung inhalers for other symptoms.

    • Diarrhea

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    What Is Sinus Infection

    Medically known as rhinosinusitis, Sinus infection or Sinusitis is an inflammation or swelling of the tissue lining the sinuses. Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection. It occurs when your nasal cavities become infected, swollen, and inflamed. Sinusitis is usually caused by a virus and often persists even after other upper respiratory symptoms are gone. In some cases, bacteria, or rarely fungus, may cause a sinus infection.

    How Do You Prevent Ear Infections

    You may be able to prevent ear some ear infections if you:

    • Use earplugs when swimming or diving
    • Dry ears thoroughly after swimming
    • Never use cotton swabs inside the ear canal
    • Wash hands properly to prevent the spread of viruses
    • Use soap and warm water and wash for at least 20 seconds
  • Do not smoke and avoid secondhand smoke
  • Get vaccinated regularly as your doctor recommends
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    When Do I Really Need Antibiotics For A Sinus Infection

    When do I really need antibiotics for a sinus infection? is a question many patients have when suffering from bothersome sinus and allergy problems. While sinus infections can be quite painful, antibiotics often do not help in treating the condition.

    Sinus infections affect approximately 37 million people in the U.S. each year and can be caused by:

    The majority of sinus infections are viral in nature, and antibiotics do not cure viral infections. Taking antibiotics for viral infections also will not:

    • Keep you from being contagious to others
    • Relieve symptoms or make you feel better

    In order to distinguish a bacterial sinus infection from an infection caused by a virus or other contributing factor, your doctor will observe your symptoms and possibly conduct other tests, such as a CT scan or cultures.

    Antibiotics are only effective on bacterial infections, and even in cases involving bacteria, the body can often cure itself of mild or moderate infections within a few days.

    Treatment For Sinusitis From A Gp

    Sinus Infections Shouldn’t be Treated with Antibiotic

    If you have sinusitis, a GP may be able to recommend other medicines to help with your symptoms, such as:

    • steroid nasal sprays or drops â to reduce the swelling in your sinuses
    • antihistamines â if an allergy is causing your symptoms
    • antibiotics â if a bacterial infection is causing your symptoms and you’re very unwell or at risk of complications

    You might need to take steroid nasal sprays or drops for a few months. They sometimes cause irritation, sore throats or nosebleeds.

    A GP may refer you to an ear, nose and throat specialist if, for example, you:

    • still have sinusitis after 3 months of treatment
    • keep getting sinusitis
    • only have symptoms on 1 side of your face

    They may also recommend surgery in some cases.

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    Other Remedies For Symptom Relief

    Staying hydrated can help thin mucus to ease congestion.

    Drinking hot liquids such as tea and broth may help relieve your symptoms. Breathing in moist air may also help relieve the discomfort that comes with nasal congestion. Try breathing in steam from the shower, a bowl of hot water, or a mug of tea.

    If your voice is hoarse, rest it by avoiding yelling, whispering, and singing.

    Placing a warm compress over the inflamed area can help reduce pressure and provide relief.

    damages the natural protective elements of your nose, mouth, throat, and respiratory system.

    If you smoke, consider quitting. Ask a doctor if you need help or are interested in quitting. Quitting may help prevent future episodes of both acute and chronic sinusitis.

    Wash your hands frequently, especially during cold and flu seasons, to keep your sinuses from becoming irritated or infected by viruses or bacteria on your hands.

    Using a humidifier during the cooler, dryer months may also help prevent sinus infections.

    Talk with a doctor to see if allergies are causing your sinusitis. If youre allergic to something that causes persistent sinus symptoms, you will likely need to treat your allergies to relieve your sinus infection.

    You may need to seek an allergy specialist to determine the cause of the allergy. The specialist may suggest:

    Keeping your allergies under control can help prevent repeated episodes of sinusitis.

    What Is Sinus Infection And How Does One Get Infected

    Sinus cavities are empty spaces in which the air flows it is located within the bones that surround our nose. When our nasal cavities become swollen, an infection may immediately follow, particularly because the sinuses were filled with germs and fluid that block the passages, which is the main reason for infection.

    Depending on the type of infection your sinus has acquired, it could last longer than you wish it would. Acute sinusitis may last for about a couple of week even when you are self-medicating. Bacterial sinusitis, those which doctors usually recommend antibiotics to cure, occur if the symptoms last for over 14 days. Nevertheless, you may be surprised at how long chronic sinusitis could last it can constantly give you trouble up to 12 weeks, especially those that are associated with certain allergies. Sinus infection can affect anyone from all the age brackets.

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    Dont Rush To Antibiotics

    The sinuses are small, hollow spaces inside the head. They drain into the nose. The sinuses often cause problems after a cold. They can also cause problems if they get blocked up from hay fever and other allergies. The medical name for sinus problems is sinusitis.

    Sinus problems can be very uncomfortable. You may feel stuffed up. You may have yellow, green, or gray mucus. And you may feel pain or pressure around your eyes, cheeks, forehead, or teeth.

    Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually do not need antibiotics. Heres why:

    Pathogenesis Of Acute Sinusitis

    Acute Sinusitis (Adults)

    Acute sinusitis usually follows an acute upper respiratory tract infection . As the viral infection spreads in the nasal mucosa, swelling and oedema of the mucosa results. As the mucosal surfaces of the ostiomeatal unit are in close proximity to one another , obstruction of the sinus ostia results. In addition, the viral infection may reduce normal cilial motility. This prevents normal muco-ciliary clearance resulting in an accumulation of mucus in the sinuses and the development of the symptoms of sinusitis. If this mucus becomes secondarily infected by bacteria, acute bacterial sinusitis develops.

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    Experts Update Best Practices For Treating The 1 In 8 Us Adults Suffering From Sinusitis

    Highlights:
    • Sinusitis affects about 1 in 8 adults in the United States, resulting in over 30 million annual diagnoses. The direct cost of managing acute and chronic sinusitis exceeds $11 billion per year.
    • More than 1 in 5 antibiotics prescribed in adults are for sinusitis, making it the fifth most common diagnosis responsible for antibiotic therapy.
    • Because sinusitis is treated differently based on its cause, it is critical to differentiate between acute viral sinusitis and acute bacterial sinusitis.
    • New evidence supports a recommendation of either watchful waiting or antibiotic therapy for mild, moderate, or even severe acute bacterial sinusitis.

    ALEXANDRIA, VA An updated clinical practice guideline from the American Academy of OtolaryngologyHead and Neck Surgery Foundation published today in OtolaryngologyHead and Neck Surgery identifies quality improvement opportunities and explicit actionable recommendations for clinicians managing adult sinusitis, including a greater focus on patient education and patient preference.

    More than ever before, there is a prominent role for shared decision-making between patients and clinicians when managing adult sinusitisespecially in deciding whether to use antibiotics for acute bacterial sinusitis or to instead try watchful waiting to see if a patient can fight the infection on his or her own.

    Richard M. Rosenfeld, MD, MPH

    Other differences between the 2007 guideline and the 2015 update include:

    Risk Of Unnecessary Antibiotics For Sinus Infections

    Taking unnecessary antibiotics for a sinus infection is not only ineffectual, but can actually be harmful to the patient. Risks of taking unneeded antibiotics include:

    • Increased chance of getting an antibiotic-resistant infection at a later time
    • Destruction of healthy stomach bacteria, which can allow harmful bacteria to grow
    • Possible side effects, such as upset stomach, rash, or dizziness
    • Allergic reaction

    According to studies conducted by the American Academy of Allergy, Asthma, and Immunology , 60-70% of patients with sinus infections fully recover without the use of antibiotics. Additional research shows that almost 90% of U.S. adults diagnosed with acute sinusitis are prescribed antibiotics.

    This overuse of antibiotics for sinus infections, as well as other conditions, can lead to antibiotic resistance, a state in which bacteria change over time as a reaction to antibiotic treatment, in order to survive and multiply, thus making the antibiotics less effective.

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    Important Factors To Keep In Mind

    • Avoid drinking alcohol and caffeinated drinks while you are on prescribed antibiotics or any sort of medicine, as alcohol intake reduces its effectiveness which makes the entire course useless.
    • While other medicines are available over-the-counter, it is much better to ask your doctor first if you have certain allergies or condition. This is to avoid unpleasant reactions because a medicines effectiveness also depends on the individuals health.
    • For a maximum result, never miss your dose on a given time. Make sure you check the labels and that you fully understand the instructions, particularly on the amount of dose that you are supposed to take.
    • If you suddenly feel that theres something wrong in your body after taking your meds, observe how it affects you. If you show severe symptoms that you are not familiar with, do not hesitate to consult your doctor.
    • Some antibiotics or medicines are not to be taken by pregnant women doctors usually recommend a certain brand for these kinds of patients.
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    What Is The Treatment For Ear Infections

    Sinusitis – 10 Tips for the Prevention and Treatment of Acute Sinusitis in Adults

    Medications used to treat ear infections include:

    • Pseudoephedrine to ease ear pressure
    • Antibiotic ear drops for infections of the ear canal
    • Neomycin
    • Polymyxin B
    • Steroid ear drops for infections of the ear canal
    • Hydrocortisone
    • Oral antibiotics for infections of the middle ear , and severe infections of the outer ear

    For mild cases of ear infection, doctors often recommend watching and waiting before starting use of antibiotics, as many cases will go away on their own. Consult your childs pediatrician before giving any over-the-counter medications to your child.

    Home remedies to relieve symptoms include:

    • Warm compresses applied to the area to help soothe pain
    • Over-the-counter pain eardrops

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    Sinus Infection Treatment In Children

    Sinus infections affect children similarly.

    If your child has a sinus infection, the aforementioned home remedies may help, but make sure to follow your pediatrician‘s recommendations to treat your child’s illness.

    Note that various over-the-counter medications may not be suitable for your child:

    • Babies 6 months old or younger should only receive acetaminophen for pain relief
    • Children older than 6 months can receive acetaminophen or ibuprofen
    • Children should never receive aspirin and teenagers recovering from chicken pox or flu-like symptoms should not take aspirin because of the risk of a rare and severe illness called Reyeâs syndrome

    Children younger than 4 years should not receive cough or cold products unless directed by a pediatrician .

    Sinusitis : Antimicrobial Prescribing

    People presenting with symptoms for around 10 days or less

    1.1.1 Do not offer an antibiotic prescription.

    1.1.2 Give advice about:

    • the usual course of acute sinusitis

    • an antibiotic not being needed

    • managing symptoms, including fever, with self-care

    • seeking medical help if symptoms worsen rapidly or significantly, do not improve after 3 weeks, or they become systemically very unwell.

    1.1.3 Reassess if symptoms worsen rapidly or significantly, taking account of:

    • alternative diagnoses such as a dental infection

    • any symptoms or signs suggesting a more serious illness or condition.

    For a short explanation of why the committee made these recommendations, see the evidence and committee discussion on no antibiotic.

    Full details of the evidence and committee discussion are in the evidence review.

    People presenting with symptoms for around 10 days or more with no improvement

    1.1.4 Consider prescribing a high-dose nasal corticosteroid for 14 days for adults and children aged 12 years and over, being aware that nasal corticosteroids:

    • may improve symptoms but are not likely to affect how long they last

    • could cause systemic effects, particularly in people already taking another corticosteroid

    • may be difficult for people to use correctly.High-dose nasal corticosteroids used in the studies were mometasone 200 micrograms twice a day and fluticasone 110 micrograms twice a day. This is an off-label use of nasal corticosteroids See NICE’s information on prescribing medicines.

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